Effectiveness of Leg Elevation to Prevent Spinal Anesthesia-Induced Hypotension during Cesarean Delivery in the Resource-Limited Area: Open Randomized Controlled Trial

Abstract

Background. Postspinal hypotension is the most common complication after spinal anesthesia for cesarean section (CS). Hypotension mainly occurs due to the reductions of vascular tone leading to decreased systemic vascular resistance and decreased venous return. The aim of this study was to assess the effectiveness of leg elevation (LE) as a method of prevention of postspinal hypotension in patients who undergo cesarean section under spinal anesthesia. Methods. This is a single-center parallel-randomized controlled trial study, and 52 full-term parturients scheduled for elective cesarean section who meets inclusion criteria were included in the study. The randomization sequence was created by a researcher not participating in patient management using a computer random generator. The participant was randomly assigned to the leg elevation group (n = 26) or to the control group (n = 26) of usual perioperative care. Results. The proportions of patients who develop hypotension are lower (8 (33.3%)) in the leg elevation group than the control group (15 (62.5%)) with an X2 (1, N = 48) = 4.09, P=0.043. The relative risk of developing postspinal hypotension in the leg elevation group compared to the control group was 0.47 (95% CI, 0.28–1.00). The proportion of severe hypotension was significantly decreased in the leg elevation group at a P value of 0.02. Conclusion. Performing leg elevation immediately after spinal anesthesia reduced the incidence of hypotension. The trial is registered with PACTR201908713181850.

Does Leg Raising Prevent Spinal-Induced Hypotension in Elective Cesarean Sections? A Randomized Controlled Study

“…the control group (33.3% vs. 62.5%, p=0.02) (9). Also, in line with the results of the study conducted by Hasanin et al, the hypotension incidence in the group administrated with a 40-degree LR in the horizontal plane was observed to be much lower than in the control group (34.7% vs. 58.7%, p=0.005) (7).…”

Prevalence and Risk Factors of Hypotension in Patients Undergoing Cesarean Section with Spinal Anesthesia at Muhimbili National Hospital

“…The proportion of patients developing hypotension in this study was 56.7%, which is consistent with previous research. (5,13,14) Hypotension is a well-known complication of spinal anesthesia, and its occurrence can have signi cant implications for both the mother and the fetus. (3)…”

Effects of Hyperbaric and Isobaric Bupivacaine on Hemodynamic Profiles and Block Characteristics Among Parturients Undergoing Elective Cesarean Section Under Spinal Anesthesia: A Randomized Controlled Trial

“…Some of the studies indicate that hyperbaric bupivacaine leads to reduced post-spinal hypotension and a quicker achievement of maximum sensory and motor block compared to isobaric bupivacaine. 16–18 Other studies found minimal post-spinal hypotension and a faster onset of block in the isobaric bupivacaine group than in the hyperbaric bupivacaine group. 18 , 19 This controversy calls for a well-designed study to compare the two groups in terms of their effects on hemodynamic profiles and block characteristics.…”